Provider Demographics
NPI:1003001652
Name:DALIP K. KHURANA, M.D., PLLC
Entity Type:Organization
Organization Name:DALIP K. KHURANA, M.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DALIP
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:KHURANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-592-4166
Mailing Address - Street 1:5 HIDDEN MDWS
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-3422
Mailing Address - Country:US
Mailing Address - Phone:716-667-3707
Mailing Address - Fax:716-592-4177
Practice Address - Street 1:15 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:14141-1000
Practice Address - Country:US
Practice Address - Phone:716-592-4166
Practice Address - Fax:716-592-4177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY139722207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RA6001OtherMEDICARE PTAN: DR KHURANA
BA0483OtherMEDICARE PTAN FOR PLLC
1578534368OtherDR DALIP KHURANA'S NPI #
BA0483OtherMEDICARE PTAN FOR PLLC